How much rates vary
Facilitymedian $3,311 · 10th to 90th $832 to $7,413Professionalmedian $417 · 10th to 90th $331 to $631
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $537.03 | Professional | None | $467.74 | $524.81 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $602.56 | Professional | None | $354.81 | $416.87 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | 50 · Both sides | $524.81 | $616.60 | $912.01 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,148.15 | $2,089.30 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $870.96 | Professional | None | $309.03 | $363.08 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $1,380.38 | Facility | None | $354.81 | $416.87 | $1,380.38 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $831.76 | Professional | None | $398.11 | $537.03 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $588.84 | Professional | None | $234.42 | $389.05 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $630.96 | Professional | None | $549.54 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,456.54 | Facility | None | $831.76 | $2,238.72 | $6,456.54 |
United Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $645.65 | Professional | None | $302.00 | $416.87 | $645.65 |
Univera Setting Facility Modifier None Typical Low $371.54 Median $398.11 Typical High $1,513.56 | Facility | None | $371.54 | $398.11 | $1,513.56 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $398.11 Typical High $588.84 | Professional | None | $234.42 | $398.11 | $588.84 |
15 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $234.42 Median $263.03 Typical High $269.15 | Professional | 52 · Reduced service | $234.42 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $104.71 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $398.11 Typical High $407.38 | Professional | 54 · Surgery only | $346.74 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $81.28 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $52.48 Typical High $53.70 | Professional | 56 · Pre-op care only | $46.77 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $371.54 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $323.59 | $371.54 | $380.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $467.74 | Professional | 54 · Surgery only | $295.12 | $354.81 | $467.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $117.49 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $58.88 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $398.11 | Professional | 53 · Discontinued | $229.09 | $288.40 | $398.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $467.74 | Professional | 54 · Surgery only | $295.12 | $354.81 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $190.55 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $43.65 Typical High $95.50 | Professional | 56 · Pre-op care only | $36.31 | $43.65 | $95.50 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $309.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $257.04 | $309.03 | $407.38 |
Where New York sits
The same service costs 6.0 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 42nd of 51
$437
AK $1,820UT $302
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.